| NPI | 1235634080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD29483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301504281) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-07-07 |